Tuesday, January 8, 2013

A BRIGHT FUTURE FOR EHRS, BUT WHEN?

A BRIGHT FUTURE FOR EHRS, BUT WHEN?

A broad consensus exists about the future viability of electronic health records, yet there remains a good deal of dissension over when and how that future arrives. Indeed, recent polling conducted by Health Data Management bears this out, with nearly equal numbers of respondents predicting either rapid or gradual growth of EHRs. The online polls, with a total of 83 respondents, were conducted as part of a December 2009 (two weeks before the interim meaningful use rules were issued) Health Data Management Webcast, "The Future of Digital Health."

Karl D. Schubert, managing partner and chief technology officer of Minnetonka, Minn.-based TechNova Consulting, falls in the latter camp of expecting a gradual expansion of EHRs. In one of a series of interviews conducted with Webcast participants after the event, he compared the adoption curve with how banks rolled out ATMs. "The future for digital health is bright, but it is not going to happen overnight. It will not be easy, and we will have to invest money to save money and improve health care in the long run."

A number of technological challenges must be surmounted before EHRs are widely adopted, Schubert says. "Today's average interaction by a health services consumer still involves a 19th century paperwork trail, and that drives costs up, efficiencies down, and improper diagnosis and treatment," he says. "There are major challenges, though, that will need to be overcome such as universal data taxonomy, ease-of-use for the consumers and providers, personal information safeguards, and checks-and-balances to ensure that the data is good and remains good."

Another source of division among survey respondents was the impact of the spending stipulated under the American Recovery and Reinvestment Act of 2009 to encourage meaningful EHR adoption (see cover story, page 40). Opinions split almost evenly among those who think federal spending will spur adoption and those who say it is too soon to tell. Twelve percent of survey respondents dismissed the stimulus efforts as a boondoggle.

Brett Harnett, research assistant professor and chief, division of I.T. at the University of Cincinnati Dept. of Surgery, says the federal push will catalyze EHR adoption. Like many other respondents, he likens the program to a mandate. Although the program does not specifically require an EHR, it does eventually penalize those without one by reducing their government reimbursements. "The government has taken a two-pronged approach to the adoption of EHRs," he says. "First by mandating it and second by incentivizing it. Although there are issues to resolve such as interoperability and unique patient identification numbers, the incentive represents a financial 'carrot' that should be embraced by providers."

Donna DuLong, a consultant at Ridgefield, Conn.-based Apelon Inc., medical terminology management software provider, agrees the stimulus will speed EHRs along the path toward widespread use. "The federal I.T. stimulus program will not only raise awareness for the need to adopt EHRs, but more importantly, fuel the debate about how EHRs need to improve our ability to deliver higher quality patient care," she says.

Erin Stevenson, a digital health care consultant at Redwood Medical Consulting, Bayside, Calif., says EHRs' ability to improve outcomes for doctors and patients will spur adoption. "There are still bumps in the road, but inevitably patients win from better and more timely and targeted treatment, potentially earlier intervention and treatment of life-altering health conditions. Doctors can improve their quality of service and bottom line, decrease mistakes, expand their patient base and have access to advanced decision support resources."